Low ferritin (20ng/ml), hypothyroid and 34 weeks pregnant. How do I increase my levels?

[Emily78]

Hi all,

I am 34.5 weeks pregnant and mostly doing really well. I've been under a lovely endocrinologist throughout my pregnancy who has kept a close eye on my T4 and T3 levels, as well as the essential vitamins and a host of other things.

All my recent blood results have come back good. My Vitamin D, folate and B12 are all top of the range. My ONLY issue is my ferritin keeps dropping and dropping, despite what I think it quite heavy iron supplementation (suspect my little one is pinching it all :-)). Early in my pregnancy my ferritin was 90ng/ml (22-322), but now towards the end it's dropped to 20ng/ml, despite doubling my iron supplements. Considering my low level, I actually feel quite well though. I mean I get tired, but I'm heavily pregnant!

I am not supposed to eat liver while pregnant (though I am not convinced it's unsafe) so I think it has to be supplements.

This is what I am currently taking daily:

-2 x 20mg Terranova Easy Iron Complex (mixed with orange juice and 1g Vit C)

-13mg Metabolics 'Ionic Iron' Liquid Ferrous Sulphate in orange juice

-1 sachet Spatone (5mg) in orange juice

I try to take these away from food and other supplements (and thyroid meds) but it's not easy because I take so many other things.

So guess I'd really like to know if anyone has any advice on what I can do? I imagine once I give birth my levels will come back up, but I don't think it's a good idea to let them drop much more as I could have 6+ weeks to go. And I don't want to end up needing an iron infusion! I am seeing my endo next week so will ask what he suggests, though I have a horrible feeling it'll be lots of tablets with nasty effects on the digestive system!

Hoping someone can help!

Thank you.

[Mwms9]

Hi your ferritin is low, are you only taking one sachet of spatone a day? That won't be enough you need iron tablets from the doctor, I'm taking ferrous fumerate, 2 tablets a day which is 420mg of iron and take it with pure orange juice or vitamin c dissolvable drinks, this helps it absorb and avoids constipation, I'd try and get an appointment with your gp as soon as you can.

[Emily78 in reply to Mwms9]

Thank you. I'll contact my GP asap. What are the vitamin C dissolvable drinks you use? I have a vit C powder that I add to orange juice currently.

[Mwms9 in reply to Emily78]

Yes they should have automatically given you some with that level especially as you are pregnant. I use vit C dissolvable from Wilko 1000mg, they don't contain aspartame which you should avoid like Berocca, and don't take zinc too close to iron as it stops it absorbing from what I've read. But I try to drink 500ml of orange juice as well, not from concentrate I buy innocent, that definitely helps with constipation. Hope you get tablets soon!

[Emily78 in reply to Mwms9]

Thank you! I've managed to arrange a phone consultation this pm, so hoping they'll run me off a prescription straight away. They will have my test results on the screen in front of them. Really can't afford to leave things like this much longer.

When I saw my latest results, it said 'Ferritin 20 ng/ml, Abnormal, No further action'! So for some reason they're ignoring it, probably because iron levels do drop in pregnancy, but they clearly don't understand the important of iron when hypothyroid.

I usually take my iron at least an hour apart from anything else and I also use 'not from concentrate' orange juice, but it gives me terrible heartburn in pregnancy so I've only been having a few mouthfuls. Will try to drink a bit more.

Thanks again for your advice.

[Raucous]

Hi Emily - I discovered a couple of years ago I had very low ferritin (but wasn't pregnant). I just wondered if you have come across the research that shows that iron supplementation may cause your body to block iron absorption? Some studies show that it is more effective to supplement on alternate days because if large amounts of iron are taken, the body will produce Hepcidin to inhibit absorption to protect from toxic overload - might be worth discussing with your endocrinologist?

here are some studies/articles I found which I think reference the same research:

hematology.org/Thehematolog...

drgreene.com/decreasing-iro...

[Emily78 in reply to Raucous]

Wow no I didn't know this! Thank you. That makes a lot of sense, and might explain why the more iron I've been taking, the lower my levels have become. I just thought it was the baby using more and more of my reserves. I'll definitely discuss this with my endo and hopefully come up with a plan to stop things getting worse. Thanks again.

[posthinking01]

Hi there - whilst I appreciate your levels are low - you do have to be careful with iron particularly when pregnant - please be careful and only supplement with iron if your medical team say so................it can affect the liver............regardless of the thyroid issue they will know what they are doing with iron.

[Emily78 in reply to posthinking01]

Thank you. I'll make sure to talk to both my GP and endo before changing anything. My recent liver blood results are good, and I hope to keep them this way!